Systemic Redox Imbalance in Chronic Kidney Disease: A Systematic Review.
Systemic Redox Imbalance in Chronic Kidney Disease: A Systematic Review.
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DOI：
10.1155/2016/8598253
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发表时间：
2016
影响因子：
--
通讯作者：
Karatzaferi C
中科院分区：
文献类型：
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作者：
Poulianiti KP;Kaltsatou A;Mitrou GI;Jamurtas AZ;Koutedakis Y;Maridaki M;Stefanidis I;Sakkas GK;Karatzaferi C
慢性肾病 (CKD) 患者的氧活性物质 (ROS) 产生与抗氧化防御之间存在不平衡，导致细胞和组织损伤。然而，目前尚不清楚肾功能不全的哪个阶段氧化还原失衡变得更加严重。本系统综述的目的是提供最新进展，以了解氧化还原状态在肾脏疾病从透析前 1 期至 4 期到终期 5 的进展过程中如何变化，以及各种治疗和透析方式是否影响氧化还原平衡。使用 Cochrane 和 PRISMA 指南检索 PubMed 和 Scopus 进行系统评价。总共有 39 项研究符合纳入标准并接受了审查。即使从早期阶段开始，氧化还原状态的不平衡就很明显，并且随着肾功能的恶化，这种不平衡会变得更加严重。血液透析治疗本身似乎会通过脂质过氧化标记物的升高、蛋白质羰基化和损害红细胞抗氧化防御来对氧化还原状态产生负面影响。然而，其他透析方式迄今为止似乎并没有带来优势。补充抗氧化剂可能有助于并应被视为一种早期干预措施，以阻止 CKD 早期阶段过早动脉粥样硬化的发展。
Patients with chronic kidney disease (CKD) experience imbalance between oxygen reactive species (ROS) production and antioxidant defenses leading to cell and tissue damage. However, it remains unclear at which stage of renal insufficiency the redox imbalance becomes more profound. The aim of this systematic review was to provide an update on recent advances in our understanding of how the redox status changes in the progression of renal disease from predialysis stages 1 to 4 to end stage 5 and whether the various treatments and dialysis modalities influence the redox balance. A systematic review was conducted searching PubMed and Scopus by using the Cochrane and PRISMA guidelines. In total, thirty-nine studies met the inclusion criteria and were reviewed. Even from an early stage, imbalance in redox status is evident and as the kidney function worsens it becomes more profound. Hemodialysis therapy per se seems to negatively influence the redox status by the elevation of lipid peroxidation markers, protein carbonylation, and impairing erythrocyte antioxidant defense. However, other dialysis modalities do not so far appear to confer advantages. Supplementation with antioxidants might assist and should be considered as an early intervention to halt premature atherogenesis development at an early stage of CKD.